On June 1st, 2017, social entrepreneurs, academics and other international development practitioners gathered to share and discuss what’s being done to tackle the root causes of disease and ill-health and contribute to healthier communities around the world?
Our panel revealed approaches to ongoing global health challenges, discussed and debated access to vaccines and other advances in health care delivery and international development.
Heather Farquharson, Director of Partnerships at CSI, moderated the discussion, asking the panel to share stories of impact, collaboration and innovation as essential to their work and the systems-change needed to eradicate disease and improve health outcomes. Finally, the panel addressed the gaps – what are the opportunities for social innovators to make lasting and positive change.
The CSI community supports over 1000 enterprises and not-for profit organizations, many of whom are working in international development and community health. Our Agents of Change: Community Health programming supports further innovation in this area.
Dr. W. Ripley Ballou MD, Vice President and Head, GSK Global Vaccines U.S. R&D Center – Dr. Ballou is an expert in vaccine development and has worked in this field for more than 30 years. Trained in Internal Medicine and Infectious Diseases, he began his work on vaccines at the Walter Reed Army Institute of Research where he led the team that with GlaxoSmithKline co-developed RTS,S, the world’s most advanced malaria vaccine. In addition to senior roles in Vaccines at GSK, he has served as Deputy Director for Vaccines, Infectious Diseases Development, Global Health at the Bill & Melinda Gates Foundation. Dr. Ballou has numerous publications in the field of vaccine development and infectious diseases.
On Impact:
“The RTS,S is the world’s most advanced [Malaria] vaccine… The WHO has gone through a long review process and earlier this year, has recommended pilot introduction of this vaccine to three countries in sub-Saharan Africa – to very significantly expand the population who is receiving the vaccine; and to look at the performance of this vaccine in real-life conditions.”
“We estimated in our Phase 3 trial that in the sites with the most intense malaria transmission for every 1000 children we vaccinated, we were averting as many as 6,000 cases of malaria per year.
“We saw an absolute efficacy rate of approximately 50% in the study population and people have said: ‘Is that good enough?’; we think that even reducing the number of infections by 50% [in this high infection-rate population], that this does have a significant impact, not only in the health of the child but on the ability of the community to manage that burden of malaria.”
On Collaboration:
“Thanks to the committed partnership of PATH and the Gates Foundation along with GSK and many others, a lot of infrastructure has been built, on the ground, which first of all allowed us to do a very high quality Phase 3 trial; involving 16,000 children, in seven countries and 11 sites – that’s a very complex Phase 3 program in areas that have never done these kinds of trials before.”
“We are talking about an order of magnitude in children being vaccinated [through the pilot program] and the ability to do that depends on the [infrastructure]. Even today it remains very challenging – we rely on our partnerships, we rely on engagement with the countries and the country health systems, this is all part of the process.”
On Innovation:
“This pilot introduction is happening in 3 of the countries where the Phase 3 trials were done and clearly, without the infrastructure and support systems put in place, over the last decade as we have been moving this [vaccine] program forward, have been critical to even the possibility of doing this pilot introduction. We are working to immunize about 700,000 children over the next 4 years and the roll-out is being done in such a way that we will be able to measure the impact on mortality, on hospitalization use and collect a much higher level of safety data.”
“Our philosophy is that innovation is not only found within our company. We are extremely collaborative and always looking for innovation outside our organization. Frequently, it is something that allows us to do our work better or do it faster or to do it at lower cost. Innovation is absolutely critical and core to R&D and we are living it every day.”
The Gaps – opportunity for social innovation:
“In the non-development clinical scenario [beyond the pilot program staffing], where the rubber meets the road is where the children and families go to get their healthcare and these are some of the most poorly supported resources within the health system in these countries. It’s a very challenging area”
Raseema Alam, Founder of Connected Development Advisers and a former Canadian diplomat. She is a graduate of the Fletcher School of Law and Diplomacy and a Rotary Peace Fellow. She has lived in 5 developing countries and has worked with the World Bank and the Gates Foundation. Raseema has extensive expertise in delivering health and humanitarian programs with the Government of Canada, having led the polio vaccine program in Afghanistan, among others; and has evaluated Canada’s health and gender policy and programming.
On Impact:
“GAVI is a network of networks and is designed to create a relationship at the input / output level- by providing vaccines lives will be saved.”
On Collaboration:
“Government is there to solve public problems and to create partnerships.” “We need to work to pave the way for the interventions in other countries – both at the government level and at the community level to be able to observe the impact.”
“In her new book, [the Chess Board and the Web] Anne-Marie Slaughter uses GAVI as a great example of the collaboration of many different actors,. She describes 5 key functions [of within the partnership]: you need connectors, communicators, cross-fertilizers and collaboration managers. But I think she has forgotten one: that is ‘coordination’, which is so important for operationalizing the delivery of vaccines.”
On Innovation:
“Another example of a Canadian social innovation is Gavin Armstrong’s Lucky Iron Fish. For this very low-cost initiative… this is a very good solution to a wide-spread problem.”
The Gaps – opportunity for social innovation:
“I don’t think that we [as a sector] are paying enough attention to the communicable disease of Tuberculosis and the drug-resistance of certain strains of TB.”
Dr. Kevin C. Kain MD, FRCPC is a Professor of Medicine, University of Toronto; Director, SAR Laboratories, Sandra Rotman Centre for Global Health; Director, Tropical Disease Unit at Toronto General Hospital; and holds a Canada Research Chair (Tier I). Dr. Kain’s research efforts are focused on new diagnostics and interventions for global infectious disease threats particularly as they pertain to women and children. Dr Kain was profiled by TIME magazine as one of “Canada’s Best in Medicine”. He has served as a consultant to many organizations including the Gates Foundation, Red Cross, PATH, and the CDC.
On Impact:
“Our approach is complementary to vaccines. Our interests, in terms of impact, are saving lives, saving brains and saving money – note that a severe infection, if you survive it, may result in a life-long potential disability and the public health implications of that are also huge.” “Our goal has been to come up with a practical tool, a point of care, where you can prick a finger and make an evidence-based decision on what each child needs… and focus limited resources on saving a life.”
“And the next part, is if you can improve the survival of that child, can you also protect their brain? How do you decrease that 30-60% brain injury? So what we’ve used are new agents to stabilize the blood-brain barrier… Our work has been to bolster us against severe infections.”
On Collaboration:
“There is meat-absence in diets in most of sub-Saharan Africa. We have a project underway to engage local food systems and locally empowered women’s groups to grow peanuts as a food-supplement which supplies a critical amino-acid, commonly found in meat, that might help to prevent pre-term birth. This is an example of empowering local groups to address a big problem.”
“Our work has to be grass-roots and integrated into the local system, otherwise it isn’t sustainable. It is foundational for us to have local partners and keep it bilateral.”
On Innovation:
“We try to be creative when solving our problems. I am too impatient to wait, the 10-20 years and $2.6 billion that it takes for a new drug to be brought to market.” Our approach is to find “druggable” pathways that improve survival and outcome. When we find those pathways, we then look at drugs that act on those pathways and that are already FDA approved… this greatly accelerates impact since it allows you to repurpose and go right to a clinical trial to prove it works. Moreover it also allows you to file a patent for a new indication and then find a local manufacturer to produce them at lower cost for the populations at risk.”
The Gaps – opportunity for social innovation:
“[As a sector], I don’t think that we are paying nearly enough attention to healthy pregnancies and birth outcomes and the critical window of development that occurs in-utero… There are new and intriguing data that many of the expensive so called non-communicable diseases such as diabetes, heart disease and even mental illnesses, may have their seeds sown in the womb and may be prevented or decreased by preventing common infections in pregnancy and improving birth outcomes. We need to move from our current model of costly long-term treatment, to prevention”
“We are very reactive in medicine and we tend to “invest” in the past – we need to invest in the future, which is to ensure the next generation of mothers and babies are healthy and able to reach their potential.”
Albert Tseng, MPA, MHSc, P.Eng, Moonspire Social Ventures, Founder & President; BlueDot, Strategic Advisor (former COO) Albert works with social enterprises, companies, development institutions, and impact investors that are engaged in sustainable business models that impact global poverty and health. Albert is Strategic Advisor (former COO) at BlueDot, a Certified B Corporation that studies how infectious diseases disperse worldwide through analysis of big data. Albert has consulted to a number of different organizations, including his role as Health Sector Lead for the United Nations Business Call to Action initiative, which works with companies that have innovative business models that combine profitability with social impact in developing countries. Previously, Albert was based in South Africa with the Clinton Foundation managing a program that worked with government, donors and private sector to improve HIV health system efficiency.
On Impact:
“Understanding what the data and science is telling you is important, but understanding how to best apply interventions, aka implementation science, is also critically important.”
On Collaboration:
“At BlueDot, in order to have the best impact possible, we are partnered with the CDC in Atlanta, the health ministries of ten countries in South-East Asia and various research institutes around the world [Oxford]”
“In developing countries, there are often very strong national strategies for addressing health challenges, however, understanding how government, NGOs, social enterprises, and communities work together to implement these strategies and interventions is often very complicated.”
On Innovation:
“BlueDot is a social enterprise spun out of St. Michael’s Hospital…Essentially, what we do is use big data and information from our partners [around the world] to understand the risks of infectious disease and how diseases might spread – diseases like Ebola, Zika and other emerging infectious diseases”
The Gaps – opportunity for social innovation:
“From Canada, because our budgets for foreign assistance are relatively small, we will need to focus on innovation to make a difference. There are great examples of small Canadian-funded projects that have become national initiatives – such as ColaLife, supplying zinc – oral rehydration salts co-packs through the retail delivery chain in Zambia – which, through the [coordination of] the private and public sector resources and systems, can have a big impact. So, whether it is vaccines, treatments or over the counter medicines, social businesses can play a big role and be one of the tools in the tool-kit needed to solve large problems.”
“One big challenge is how we get the world to be more aware of how our behaviors as humans has an impact on the world ; such as overuse of antibiotics in the livestock industry and the impact of that on anti-microbial resistance, etc.”
This opportunity to educate & engage is thanks to our supporting partner, GlaxoSmithKline Inc.– whose dedication to “improving the quality of human life by enabling people to do more, feel better, live longer” is a commitment we share.
